Impact of DIP Reform on Hospitalization Costs and Structural Changes: An Analysis Based on 12-Year Time-Series Data from Tertiary A Hospitals

Corresponding author: XUE-yunlian, xueyunlian@163.com

DOI: 10.12201/bmr.202603.00043

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  Abstract: Objective: To explore the impact of the Diagnosis-Intervention Packet (DIP) payment reform on the trends and structure of hospitalization costs, evaluate the effectiveness of the reform, and provide empirical references for medical insurance policy adjustments. Methods: Based on hospitalization cost data from a tertiary grade-A hospital in Guangzhou from 2013 to 2024, an interrupted time series model was constructed. Combined with grey relational analysis and structural variation analysis, the impact of the DIP reform on average hospitalization costs per visit and their internal composition was analyzed from multiple dimensions. Results: The DIP reform effectively curbed the rapid growth of hospitalization costs. After the reform, the annual growth trend of the average total hospitalization cost per visit (β_3) decreased by 383.97 CNY compared to the pre-reform period (P＜0.001). The structural variation value of drug costs was the largest, showing negative growth in most years; conversely, consumable costs showed positive growth in most years, serving as the primary positive driving factor for structural variation. Conclusion: The DIP reform has successfully achieved control over total hospitalization costs and promoted the transformation of the nourishing medicine with drugs mechanism, with initial success seen in cost structure optimization. However, the compensatory growth of consumable costs has emerged as a new challenge. Recommendations: It is suggested to deepen the refined management and pricing of high-value consumables, optimize the design of the DIP payment system, strengthen multi-party collaborative governance, and seek the optimal balance between cost control and quality to promote the continuous optimization of the DIP reform.

  Key words: DIP; Hospitalization expenses; Interrupted time series; 

  Submit time: 11 March 2026

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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